CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Coral Gables Hospital

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$20,201

about 1.4× the $14,044 Medicare rate · typically $16,307–$22,958

modeled estimate · not a bill or quote

What this hospital charges insurers

$22,077

About the fair price

about $1,876 over the fair price · 1.6× Medicare

Medicare pays $14,044 Fair price $20,201 This hospital $22,077

How we calculate the fair BaseRate →

How this hospital compares to other FL hospitals

Highest price of the 9 FL hospitals we have prices for — worth calling around.

Cheapest $9,376 Priciest $22,077

Black dot = this hospital, among the 9 FL hospitals with a price for this procedure. Full list below.

A fair price for a Hip or knee replacement (inpatient stay) is about $20,201 (about 1.4× the $14,044 Medicare rate). Coral Gables Hospital charges insurers about $22,077 — about the fair price. Located in Coral Gables, FL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Aetna✓ Cigna✓ Humana Blue Cross Blue ShieldKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$15,662 - $33,062	112%
Aetnamajor	$2,169 - $15,662	15%
Cignamajor	$16,445 - $23,569	117%
Humanamajor	$3,350 - $15,348	24%
Ambetter (Centene)	$29,502	210%
AmeriHealth	$34,286	244%
AvMed	$24,736 - $32,576	176%
Bright Health	$19,136	136%
Devoted Health	$15,662	112%
Molina	$20,346	145%
Oscar Health	$17,776	127%
+ 14 smaller / regional plans	$2,283 - $39,367

Government programs also on file: Medicare, Military & VA.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 470.

Insurance Before you use insurance

Call your insurance company to confirm Coral Gables Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 470.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Coral Gables Hospital

Compare: Hip or knee replacement (inpatient stay) at other FL hospitals

Palm Beach Gardens Medical Center · Palm Beach Gardens $9,376
Sacred Heart Hospital on the Emerald Coast · Miramar Beach $11,614
Ascension Sacred Heart Gulf · Port Saint Joe $11,774
Sacred Heart Hospital · Pensacola $12,400
Jay Hospital · Jay $14,553
Gulf Breeze Hospital · Gulf Breeze $14,745
Villages Regional Hospital, The · The Villages $15,040
HCA Florida Pasadena Hospital A Part of HCA Florid · Saint Petersburg $15,054

Insurance negotiated median for the same procedure, sorted lowest first.